My being lazy and better at the graphic side than code...my medium images are for a matt of 200x160 are around 10k and the small images are about 5k. So for a slight hit on total page size, I would use the larger image as my main image and set the dimensions for the featured image in admin > images > Image - Featured Products Width and Image - Featured Products Height which are by default 100x80 and make them proportionally correct in one dimemsion, either width or height and set the other to '0' (hint from jettrue). Zen Cart will down size these for other displays according to the settings.
If you do not like this approach you will have to hack the code for the featured product image display. I think that the image calls are in tpl_modules_products_featured_listing.php and you need to hi-jack the code for the medium image and use calls similar to those found in tpl_modules_main_product_image.php.